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Fragile X Syndrome-15269

Test info

Test name:

Fragile X Syndrome

Test number:

15269

Excellian order number:

LAB15269

Abbreviation:

FRAXCA

Alternate names:

Fragile X testing
FMR1

Useful for:

This test is used for diagnostic testing and carrier screening for fragile X syndrome.

Specimen

Specimen type:

EDTA whole blood

Collection container:

Lavender (EDTA), 4mL x 3

Lavender (EDTA), 10mL

Volume:

8.5 mL

Minimum volume:

3.0 mL

Collection instructions:

Immediately following collection, mix by inverting 8 - 10 times to prevent clotting

Processing instructions:

Do not spin
Submit original tube

Transport container:

Lavender (EDTA), 4mL x 3

Lavender (EDTA), 10mL

Alternate specimen type:

ACD whole blood

Alternate collection container:

Yellow ACD (A or B)

Alternate transport container:

Yellow ACD (A or B)

Required forms/information:

Molecular Medicare billing request

Hospital clients submitting a request for this assay on an outpatient with Medicare should complete and submit a Molecular Medicare billing request form to notify us of the need for Allina Health Laboratory to bill insurance.

Transport and stability:

Ambient (preferred) - 14 days

Refrigerated - 30 days

Frozen - NO

Reason for rejection:

Frozen or hemolyzed specimens

Performance

Performing lab:

LabCorp RPT (481684); R-LC

TAT:

8 - 14 days
In some cases, additional time may be required for confirmatory or reflex tests.

Method:

Polymerase chain reaction (PCR) followed by capillary electrophoresis for detection of CGG repeats, with reflex to AGG interruption analysis for CGG repeat sizes of 55-90 and methylation PCR analysis for CGG repeat sizes >149

Clinical and Interpretive info

Reference ranges:

See report

Billing

Preauthorization:

This test may require preauthorization from the insurance provider. Check the payer guidelines and, if needed, obtain the pre-authorization prior to sample collection.

CPT codes:

81243

Subject to medical necessity (Y/N):

Yes

Other billing information:

Medical necessity

Molecular Medicare Billing Request

Tracking

Date created:

05/23/2024

Revised date:

02/25/2026

Review date:

02/25/2026